Description and follow-up of patients with coronary perforations during percutaneous coronary interventions at AFIC-NIHD

This study was conducted to determine the frequency and describe the lesion characteristics, clinical factors, device responsible and outcomes for coronary perforations at Armed Forces Institute of Cardiology - National Institute of Heart Diseases [AFIC -NIHD] on all patients undergoing percutaneous coronary interventions [PCI] from 2007 to May 2012. A total of 13,366 PCI procedures were performed during this period; coronary perforation occurred in 16 cases [0.001%]. All patients had elective PCI. Fifty percent [n = 8] patients had type C lesions. Grade III perforations were seen in 10 patients. Seven perforations were caused by angiography wires. None of the perforations was related to atherectomy devices. Six patients needed pericardiocentesis. There were 3 in-hospital deaths. One patient needed CABG. At followup, all patients who had been discharged were alive. The frequency of coronary perforations was very low. Old age and type C lesions were identified as a risk factor for coronary perforations. Grade III [or greater] perforation was a predictor of mortality. Patients who are discharged to home generally had better outcomes.